§36-6060.3.

§36-6060.3.
   
   A. Every health benefit plan contract issued, amended, renewed or
   delivered on or after July 1, 1996, that provides maternity benefits
   shall provide for coverage of:
   
   1. A minimum of forty-eight (48) hours of inpatient care at a
   hospital, or a birthing center licensed as a hospital, following a
   vaginal delivery for the mother and newborn infant after childbirth,
   except as otherwise provided in this section;
   
   2. A minimum of ninety-six (96) hours of inpatient care at a hospital
   following a delivery by caesarean section for the mother and newborn
   infant after childbirth, except as otherwise provided in this section;
   and
   
   3. a. Postpartum home care following a vaginal delivery if childbirth
   occurs at home or in a birthing center licensed as a birthing center.
   The coverage shall provide for one home visit within forty-eight (48)
   hours of childbirth by a licensed health care provider whose scope of
   practice includes providing postpartum care. Visits shall include, at
   a minimum:
   
   (1) physical assessment of the mother and the newborn infant,
   
   (2) parent education, to include, but not be limited to:
   
   (a) the recommended childhood immunization schedule,
   
   (b) the importance of childhood immunizations, and
   
   (c) resources for obtaining childhood immunizations,
   
   (3) training or assistance with breast or bottle feeding, and
   
   (4) the performance of any medically necessary and appropriate
   clinical tests.
   
   b. At the mother's discretion, visits may occur at the facility of the
   plan or the provider.
   
   B. Inpatient care shall include, at a minimum:
   
   1. Physical assessment of the mother and the newborn infant;
   
   2. Parent education, to include, but not be limited to:
   
   a. the recommended childhood immunization schedule,
   
   b. the importance of childhood immunizations, and
   
   c. resources for obtaining childhood immunizations;
   
   3. Training or assistance with breast or bottle feeding; and
   
   4. The performance of any medically necessary and appropriate clinical
   tests.
   
   C. A plan may limit coverage to a shorter length of hospital inpatient
   stay for services related to maternity and newborn infant care
   provided that:
   
   1. In the sole medical discretion or judgment of the attending
   physician licensed by the Oklahoma State Board of Medical Licensure
   and Supervision or the Oklahoma Board of Osteopathic Examiners or
   certified nurse midwife licensed by the Oklahoma Board of Nursing
   providing care to the mother and to the newborn infant, it is
   determined prior to discharge that an earlier discharge of the mother
   and newborn infant is appropriate and meets medical criteria contained
   in the most current treatment standards of the American Academy of
   Pediatrics and the American College of Obstetricians and Gynecologists
   that determine the appropriate length of stay based upon:
   
   a. evaluation of the antepartum, intrapartum and postpartum course of
   the mother and newborn infant,
   
   b. the gestational age, birth weight and clinical condition of the
   newborn infant,
   
   c. the demonstrated ability of the mother to care for the newborn
   infant postdischarge, and
   
   d. the availability of postdischarge follow-up to verify the condition
   of the newborn infant in the first forty-eight (48) hours after
   delivery.
   
   A plan shall adopt these guidelines by July 1, 1996; and
   
   2. The plan covers one home visit, within forty-eight (48) hours of
   discharge, by a licensed health care provider whose scope of practice
   includes providing postpartum care. Such visits shall include, at a
   minimum:
   
   a. physical assessment of the mother and the newborn infant,
   
   b. parent education, to include, but not be limited to:
   
   (1) the recommended childhood immunization schedule,
   
   (2) the importance of childhood immunizations, and
   
   (3) resources for obtaining childhood immunizations,
   
   c. training or assistance with breast or bottle feeding, and
   
   d. the performance of any medically necessary and clinical tests.
   
   At the mother's discretion, visits may occur at the facility of the
   plan or the provider.
   
   D. The plan shall include but is not limited to notice of the coverage
   required by this section in the plan's evidence of coverage, and shall
   provide additional written notice of the coverage to the insured or an
   enrollee during the course of the insured's or enrollee's prenatal
   care.
   
   E. In the event the coverage required by this section is provided
   under a contract that is subject to a capitated or global rate, the
   plan shall be required to provide supplementary reimbursement to
   providers for any additional services required by that coverage if it
   is not included in the capitation or global rate.
   
   F. No health benefit plan subject to the provisions of this section
   shall terminate the services of, reduce capitation payments for,
   refuse payment for services, or otherwise discipline a licensed health
   care provider who orders care consistent with the provisions of this
   section.
   
   G. As used in this section, "health benefit plan" means individual or
   group hospital or medical insurance coverage, a not-for-profit
   hospital or medical service or indemnity plan, a prepaid health plan,
   a health maintenance organization plan, a preferred provider
   organization plan, the State and Education Employees Group Health
   Insurance Plan, any program funded under Title XIX of the Social
   Security Act or such other publicly funded program, and coverage
   provided by a Multiple Employer Welfare Arrangement (MEWA) or employee
   self-insured plan except as exempt under federal ERISA provisions.
   
   H. The Insurance Commissioner shall promulgate any rules necessary to
   implement the provisions of this section.